Individual provider · Type 1 NPI

Odessa Ann Bacon, ARNP, PMHNP-BC

Psychiatric/Mental Health Nurse Practitioner · Lakewood, WA

NPI number 1801077169 Active

Practice location

9330 59th Ave SW
Lakewood, WA 98499-2858

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000XRN00175337 (WA)
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XAP61005962 (WA)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1801077169

Odessa Ann Bacon, ARNP, PMHNP-BC's National Provider Identifier is 1801077169, issued on Nov 15, 2007. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Lakewood, WA. The record was last updated on Nov 4, 2019.